Salisbury VAMC director refuses to answer questions after OIG finds wait times altered

Salisbury VA director dodges questions

SALISBURY, NC (WBTV) - The director of the Salisbury VA Medical Center refused to answer questions from On Your Side Investigates on Wednesday, just a day after the VA Inspector General released an investigative report outlining efforts by her employees to falsify wait time data.

On Your Side Investigates first reported the investigative summary Tuesday night.

Investigators with the IG's office found some scheduling employees were ordered by supervisors to alter appointments for veterans so that it appeared as though veterans were being seen within 14 days of their preferred appointment date; a standard set by VA administrators in Washington.

According to the investigative summary, some employees were instructed to "fluff the numbers" to make it appear as though veterans were being seen within 14 days. Other employees, the summary said, were disciplined for not manipulating wait time data.

"LPN2 stated that her supervisor threatened to take away her ability to schedule patient appointments if she continued to schedule appointments with wait times exceeding 14 days and was told to 'do it appropriately.' She was told in a performance review that she was 'argumentative' due to her constantly scheduling appointments with wait times exceeding 14 days and continuing to show up on the MUMPS report," the report said.

The summary said some supervisors and administrators—including Salisbury VAMC Director Kaye Green—were evaluated, in part, on the amount of appointments scheduled within 14 days of a veteran's preferred appointment date.

Document: Click here to read the full investigative summary 

"…instances were found in which the number of appointments scheduled within 14 days of the desired date was listed as criteria on VAMC Salisbury employees' yearly performance appraisals, as well as being a component of the VAMC Director's performance plan sent from VISN staff."

Salisbury VAMC director issues statement, refuses interview

The investigative summary said Green purported to have undertaken several  in-house audits of the wait time data prior to the investigation and did not find any irregularities, a claim she reinforced in a press release issued Wednesday night.

"The facility proactively implemented scheduling audits in 2013 to ensure staff were scheduling according to VA guidelines," Green said in the e-mailed statement Wednesday night. "An automated audit tool was imported from a VA facility on the West Coast, and audits using this tool have continued to this date."

But Green's statement did not address why her audits did not catch the irregularities in scheduled appointments like the OIG investigators did when they looked at the same information.

"VA OIG reviewed a report of all appointments scheduled by facility staff on May 15-16, 2014. Review of the report revealed that more than 7,500 appointments were made over the 2-day time period, and an abnormally large number of the appointments were made with a wait time of zero days, even appointments that were made several months into the future," the investigative summary said.

Green's written statement also said all of the employees identified in the OIG investigation as ordering employees to manipulate wait time data either no longer work at the Salisbury VAMC or are no longer in supervisory roles. The statement also said employees involved in manipulating wait times are being re-trained.

"To be fully transparent, we want to share the results along with our significant improvements and progress since that time," Green said in the written statement.

But multiple spokesmen for Green at the Salisbury VAMC did not respond to repeated emails requesting an interview with Green sent Tuesday night and again Wednesday afternoon. And when On Your Side Investigates approached Green outside of her office Wednesday night to try and ask questions about the investigation's findings, she refused to talk with us.

What has yet to be answered is whether Green received any bonus money as a result of the improved, manipulated appointment data.

Second OIG report released

The VA OIG released a second report Tuesday night that found a years-long backlog persists at the Salisbury VAMC's radiology department.

In the report, which was separate from the investigation into the manipulated wait times, auditors found a backlog of more than 3,000 radiology appointments.

The report said that backlog had been cut in half to just 1,358 by March 2016.

In her written statement issued Wednesday night, Green said she and her staff had proactively implemented new processes to further address the backlog, including adding services at the Charlotte and Kernersville Health Care Centers (HCC).

"As of September, both HCCs have already expanded clinical offerings, increasing access to medical services previously offered exclusively at the Salisbury VAMC. Expanded HCC services include physical therapy and rehabilitation medicine, hematology/oncology, gastroenterology, dental, and cardiac catheterization coming to the Kernersville facility in the near future," the statement said.

Lawmakers respond to OIG's findings

Congressman Robert Pittenger (R-09) responded to the report's findings Wednesday.

"The Salisbury VA Inspector General report is replete with a lack of accountability and the self-serving interests of employees.  Staff was more focused on serving the bureaucracy than serving our brave veterans," Pittenger said.  "This is what happens when leadership, including President Obama and the VA Secretary, don't pay serious attention to management oversight while civil service employees have job protections securing their employment.  They don't understand the concept that you inspect what you expect.  Bureaucrats cooked the numbers to make everything look great.

Senator Richard Burr (R-NC) also weighed in on the VA's continued problems in an interview with On Your Side Investigates.

"I think the VA is in worse shape today than when this whole issue was exposed," Burr said. "These things are unacceptable in any healthcare system, much less the VA."

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